Skin and soft tissue defects around the knee joints are often accompanied by popliteal artery injury, patellar ligament injury, patellar fracture, and other deep tissue damage or exposure, making them challenging to repair. The principle is to repair the wound, reconstruct anatomical structure of the knee joint, and recover the knee joint function. At present the reconstruction with skin flap or myocutaneous flap is our priority. Local flap or myocutaneous flap can be used for repairing minor defects around the knee joints. Repairing with perforator flap, fascia flap, and free flap are main alternatives for covering larger and complex defects around the knee joints. During the treatment, a joint effort is mandatory, not only to repair the wound, but also to reconstruct vasculature, fix fracture, repair ligament, and finally recover the knee joint function. Therefore, the importance of multidisciplinary cooperation must be emphasized. Moreover, along with the development of new technologies, new methods, and new materials, perforator flap plays an important role in repairing skin and soft tissue defects around the knee joints.